Dynamic hand splints

ABSTRACT

A dynamic hand splint includes as elements thereof: a forearm support section and a hand support section that are configured to be releasably attached to a forearm; and one or more finger tensioners that are releasably attached to the hand support section and that are configured to be releasably attached to a respective finger such that, when the finger is flexed from an extended position toward a flexed position, the finger is urged by the finger tensioner toward an extended position. A method includes: attaching a forearm support section and a hand support section to a forearm; attaching finger tensioners to the hand support section; and attaching each of the finger tensioners to a respective finger such that, when the finger is flexed from an extended position toward a flexed position, the finger is urged by the finger tensioner toward an extended position.

CLAIM OF PRIORITY

The present application is a continuation of U.S. patent applicationSer. No. 11/164,954, filed Dec. 12, 2005, now U.S. Pat. No. 7,892,194,which is a non-provisional patent application of, and claims priorityunder 35 U.S.C. §119(e) to, U.S. Provisional Patent Application Ser. No.60/635,332, filed Dec. 10, 2004, the entire disclosures of which areincorporated by reference herein.

COPYRIGHT STATEMENT

All of the material in this patent document is subject to copyrightprotection under the copyright laws of the United States and othercountries. The copyright owner has no objection to the facsimilereproduction by anyone of the patent document or the patent disclosure,as it appears in official governmental records but, otherwise, all othercopyright rights whatsoever are reserved.

FIELD OF THE INVENTION

The present invention generally relates to orthoses and, in particular,to dynamic hand splints.

BACKGROUND OF THE INVENTION

Many people suffering a neurological injury from stroke, cerebral palsy,brain injury, etc., have upper extremity impairments. Many have someshoulder and elbow movements, but are unable to extend their wrist orfingers to grasp an object. This is usually due to hypertonicity,described in U.S. Pat. No. 5,807,293 as a condition where the flexor orextensor muscles in the upper extremities are spastic and resistpositioning Dynamic splints can be used to offer slight resistance tohold joints in certain positions. An effective dynamic splint designedto be used for hypertonicity must offer enough force to balance theeffects of the increased muscle tone. Such a dynamic splint is disclosedand described, for example, in United States Patent ApplicationPublication No. US200310162634 to Farrell et al. Embodiments of thepresent invention present yet additional, alternative designs for adynamic splint.

SUMMARY OF THE INVENTION

The present invention includes many aspects and features. Moreover,while many aspects and features relate to dynamic hand splints andorthoses, and are described in detail with respect to preferredembodiments illustrated in the drawings, the present invention is notlimited to such preferred embodiments.

A dynamic hand splint includes as elements thereof: a forearm supportsection and a hand support section that are configured to be releasablyattached to a forearm; and one or more finger tensioners that arereleasably attached to the hand support section and that are configuredto be releasably attached to a respective finger such that, when thefinger is flexed from an extended position toward a flexed position, thefinger is urged by the finger tensioner toward an extended position.

In a feature of the invention, each finger tensioner is semi rigid andextends outwardly from the hand support section in a direction away fromthe forearm support section.

In another feature, each finger tensioner comprises a resilient strutand includes a strap proximate a distal end thereof that is dimensionedand configured to wrap about a distal end of a respective finger towhich the finger tensioner is to be attached. The strut may comprise aresilient rod or a strip of spring steel.

In a feature of the invention, the finger tensioners comprise resilientstruts having varying degrees of resistance.

In another feature, the dynamic hand splint further includes a fingersleeve having a pocket in which a finger tensioner extends. The pocketpreferably is configured to extend along a dorsal side of the sleeve,and the finger tensioner preferably comprises a resilient rod or a stripof spring steel.

In still yet another feature, the finger tensioner comprises a resilientband that is threaded through a plurality of raised guides that aresecured to a respective digit sleeve. The finger tensioner preferably isthreaded through the guides from the distal portion of the digit sleeveto the proximal portion of the distal sleeve and includes a stop or capfor engaging the distal guide to keep the band from being completelypulled through the distal guide. The guides are raised and serve tosupport the band at a point above the sleeves and out of abutment withone or more joints of the digits, especially during flexion of thefinger.

In a feature of the invention, the forearm support section comprises aflexible tubular member that is dimensioned and configured to surroundand provide a friction, interference fit on a forearm. The forearmsupport section may comprise a strap configured to be wrapped about saidflexible tubular member to secure the forearm support section to theforearm, with the strap including hook-and-loop type elements forengaging corresponding hook-and-loop type elements on an outer surfaceof the flexible tubular member. Additionally, the hook-and-loop typeelements on the outer surface of the flexible tubular member preferablyare integrally formed as part of the flexible tubular member during aninjection molding process. The hand support section also may include anarea of hook-and-loop type elements on a volar side of a base thereofand the forearm support section may include an area of matinghook-and-loop type elements on a dorsal side thereof, wherein the handsupport section and the forearm support section comprise non-integralpieces releasably attached together.

In a feature of the invention, the forearm support section comprises amalleable material and includes a bend therein, whereby the forearmsupport section is configured to determine an angle at which a wristwill be disposed relative to a forearm when the forearm support sectionis donned.

In still yet another feature, each finger tensioner is pivotally mountedto the hand support section for rotational (adductional and abductional)movement relative to the hand support section, whereby the fingertensioners may be splayed. Once properly oriented, a screw can betightened to lock the tensioner in the desired orientation.

Each finger tensioner also may be mounted to the hand support sectionthrough a member that is mounted to the hand support section for slidingmovement relative thereto, in accordance with still yet another feature.In this respect, each finger tensioner preferably is thereby linearlymovable relative to the hand support section to allow the fingertensioners to travel with and remain positioned over the respectivefinger throughout flexion and extension. The member preferably slides ona housing and the housing preferably includes a compression spring thatis configured to collectively urge the finger tensioners toward thehousing upon flexing of the fingers to which the finger tensioners areattached. Alternatively, a compression spring could be configured tourge a single finger tensioner toward the housing upon flexing of thefinger to which the finger tensioner is attached.

In still yet another feature, the dynamic hand splint additionallyincludes: a thumb support section releasably attached to the forearmsupport section; and a thumb tensioner releasably attached to the thumbsupport section and configured to be releasably attached to a thumb suchthat, when the thumb is flexed from an extended position toward a flexedposition, the thumb is urged by the thumb tensioner toward an extendedposition. With respect to this feature, actuation of the thumb tensionerpreferably does not actuate a finger tensioner (i.e., they are notinterconnected to move together). Similarly, actuation of a fingertensioner does not actuate the thumb tensioner.

In another feature of the invention, the forearm support sectionincludes an interior surface comprising a removable padded lining. Thelining further may include a non-skid material in order to preventdistal migration of said forearm support section. The same or a similarnon-skid material may be included on the volar sides of digit sleevesand/or on a palm covering to assist in gripping of an object by the handusing the dynamic hand splint.

In still yet another feature, the hand support section includes, on adorsal side thereof, quick-release attachment sites for changing of thefinger tensioners releasably attached to the hand support section. Bychanging of the finger tensioners, differing resistances to the flexingof the fingers can readily and easily be provided.

Another aspect of the invention includes a method for donning elementsof a dynamic hand splint, comprising the steps of: attaching a forearmsupport section and a hand support section to a forearm; attachingfinger tensioners to the hand support section; and attaching each of thefinger tensioners to a respective finger such that, when the finger isflexed from an extended position toward a flexed position, the finger isurged by the finger tensioner toward an extended position.

In accordance with a feature of this aspect, each of the fingertensioners extends between the finger to which it is attached and thehand support section.

In another feature, the step of attaching each of the finger tensionersto a respective finger comprises strapping a distal end of a resilientstrut to a distal end of the respective finger. Preferably, the strutcomprises a resilient rod or a strip of spring steel.

In still yet another feature, the step of attaching each of the fingertensioners to a respective finger comprises inserting a resilient strutinto a pocket of a sleeve in which the respective finger is disposed.Preferably a finger tensioner is secured to a dorsal side of arespective finger, and the finger tensioner comprises a resilient rod ora strip of spring steel.

In another feature, the step of attaching each of the finger tensionersto a respective finger comprises threading a resilient band through aplurality of guides that are secured to a sleeve in which a respectivedigit is disposed. The guides preferably are secured to a dorsal side ofthe respective digit, with a guide being disposed on each phalanx of thedigit.

In another feature, the step of attaching finger tensioners to the handsupport section comprises attaching finger tensioners to the handsupport section at the base of the respective finger proximate thedorsum of the hand, each finger tensioner extending only between suchpoint of attachment to the hand support section and the distal end ofthe respective finger to which the finger tensioner is attached.

In another feature, the step of attaching a forearm support section anda hand support section to a forearm comprises the step of partiallyencircling a forearm with a flexible tubular member that is dimensionedto provide a friction, interference fit on the forearm. In this regard,the method may further comprise the step of fastening a strap about theflexible tubular member to secure the forearm support section to theforearm, the strap including hook-and-loop type elements for engagingcorresponding hook-and-loop type elements on the outer surface of theflexible tubular member. The hook-and-loop type elements on the outersurface of the flexible tubular member also may be integrally formedwith the flexible tubular member during an injection molding process.The step of attaching a support comprising a forearm support section anda hand support section to a forearm also may comprise engaging an areaof hook-and-loop type elements on a volar side of a base of the handsupport section to an area of hook-and-loop type elements on a dorsalside of the forearm support section, wherein the hand support sectionand the forearm support section comprise non-integral pieces. In thisrespect, the hook-and-loop fasteners connect together the forearmsupport section and the hand support section. The method also mayfurther comprise the step of fastening a strap about the flexibletubular member and the base of the hand support section thereby securingthe hand support section to the forearm support section, the strapincluding hook-and-loop type elements for engaging correspondinghook-and-loop type elements on the outer surface of the flexible tubularmember.

In still yet another feature, the step of attaching a forearm supportsection and a hand support section to a forearm comprises the steps ofwrapping a strap about the forearm and attaching opposite ends of thestrap to the forearm support section, the hand support section and theforearm support section being integral and forming a single element ofthe dynamic hand splint. The forearm support section and the handsupport section may be integrally formed together in an injectionmolding process in this regard.

In another feature of the invention, the method further includes thestep of bending the hand support section prior to attaching the handsupport section to the forearm support section in order to determine theangle at which the wrist will be disposed to the forearm, the step ofattaching the hand support section to the forearm support sectionincluding positioning of the bend in the hand support section proximatethe wrist.

In another feature, the hand support section extends between the dorsumof the hand proximate the base of the fingers to only a few inches pastthe wrist along the forearm.

In still yet another feature, the step of attaching finger tensioners tothe hand support section includes orienting each finger tensioner aboutan axis that is generally orthogonal to the ulnar-radial plane wherebyadjacent fingers are splayed in the ulnar and/or radial direction.

In an additional feature, the step of attaching finger tensioners to thehand support section includes attaching the finger tensioner to a memberthat is mounted to the hand support section for sliding movementrelative thereto.

In still another feature, the method further includes the steps of:attaching a thumb support section to the forearm support section;attaching a thumb tensioner to the thumb support section; and attachingthe thumb tensioner to a thumb such that, when the thumb is flexed froman extended position toward a flexed position, the thumb is urged by thethumb tensioner toward an extended position. In this regard, the thumbpreferably is urged toward an extended position independent of anyurging of a finger toward an extended position by a finger tensioner.Also, a finger preferably is urged toward an extended positionindependent of any urging of the thumb toward an extended position bythe thumb tensioner.

In still yet another feature, the method includes the additional stepsof: detaching each of the finger tensioners from the respective finger;and detaching the finger tensioners from the hand support section. Themethod also may include the steps of: attaching a thumb support sectionto the forearm support section; attaching a thumb tensioner to the thumbsupport section; and attaching the thumb tensioner to a thumb such that,when the thumb is flexed from an extended position toward a flexedposition, the thumb is urged by the thumb tensioner toward an extendedposition independent of any finger tensioners, the finger tensionershaving previously been detached. Thereafter, the method may include thesteps of: detaching the thumb tensioner from the thumb; detaching thethumb tensioner from the thumb support section; detaching the thumbsupport section from the forearm support section; and detaching theforearm support section from the forearm.

In another aspect, a method for donning elements of a dynamic handsplint by a patient includes the steps of: attaching a forearm supportsection to a forearm; next, attaching the digit tensioners to respectivedigits (fingers and/or thumb), the digit tensioners being releasablyattached to a hand support section; and next, attaching the hand supportsection to the forearm support section, wherein, when the digits areflexed from an extended position toward a flexed position, the digitsare urged by the tensioners toward an extended position.

In a feature of this aspect, the hand support section is semirigid andthe step of attaching the hand support section to the forearm supportsection comprises pivoting of the hand support section about the wristinto engagement with the forearm support section with the tensionersalready attached to the digits.

In addition to the aforementioned aspects and features of the presentinvention, it should be noted that the present invention furtherincludes the various possible combinations of such aspects and features.Examples of such combinations are illustrated in the detaileddescription set forth below.

BRIEF DESCRIPTION OF THE DRAWINGS

One or more preferred embodiments of the present invention now will bedescribed in detail with reference to the accompanying drawings, whichare for the purpose only of illustrating embodiments of the inventionand are not intended to be to scale:

FIG. 1A is a top view of a dynamic splint in accordance with a firstpreferred embodiment of the present invention.

FIG. 1B is a top view of the hand and forearm support sections and clipsof the dynamic splint of FIG. 1A.

FIG. 1C is a cross-sectional view of a strut and clip of the dynamicsplint of FIG. 1A, taken along line C-C.

FIG. 2A is a perspective view of a dynamic splint in accordance with asecond preferred embodiment of the present invention.

FIG. 2B is an exploded perspective view of the dynamic splint of FIG.2A.

FIG. 3A is a perspective view of a dynamic splint in accordance with athird preferred embodiment of the present invention.

FIG. 3B is an exploded perspective view of the dynamic splint of FIG.3A.

DETAILED DESCRIPTION OF THE INVENTION

As a preliminary matter, it will readily be understood by one havingordinary skill in the relevant art (“Ordinary Artisan”) that the presentinvention has broad utility and application. Furthermore, any embodimentdiscussed and identified as being “preferred” is considered to be partof a best mode contemplated for carrying out the present invention.Other embodiments also may be discussed for additional illustrativepurposes in providing a full and enabling disclosure of the presentinvention. Moreover, many embodiments, such as adaptations, variations,modifications, and equivalent arrangements, will be implicitly disclosedby the embodiments described herein and fall within the scope of thepresent invention.

Accordingly, while the present invention is described herein in detailin relation to one or more embodiments, it is to be understood that thisdisclosure is illustrative and exemplary of the present invention, andis made merely for the purposes of providing a full and enablingdisclosure of the present invention. The detailed disclosure herein ofone or more embodiments is not intended, nor is to be construed, tolimit the scope of patent protection afforded the present invention,which scope is to be defined by the claims and the equivalents thereof.It is not intended that the scope of patent protection afforded thepresent invention be defined by reading into any claim a limitationfound herein that does not explicitly appear in the claim itself.

Thus, for example, any sequence(s) and/or temporal order of steps ofvarious processes or methods that are described herein are illustrativeand not restrictive. Accordingly, it should be understood that, althoughsteps of various processes or methods may be shown and described asbeing in a sequence or temporal order, the steps of any such processesor methods are not limited to being carried out in any particularsequence or order, absent an indication otherwise. Indeed, the steps insuch processes or methods generally may be carried out in variousdifferent sequences and orders while still falling within the scope ofthe present invention. Accordingly, it is intended that the scope ofpatent protection afforded the present invention is to be defined by theappended claims rather than the description set forth herein.

Additionally, it is important to note that each term used herein refersto that which the Ordinary Artisan would understand such term to meanbased on the contextual use of such term herein. To the extent that themeaning of a term used herein—as understood by the Ordinary Artisanbased on the contextual use of such term—differs in any way from anyparticular dictionary definition of such term, it is intended that themeaning of the term as understood by the Ordinary Artisan shouldprevail.

Furthermore, it is important to note that, as used herein, “a” and “an”each generally denotes “at least one,” but does not exclude a pluralityunless the contextual use dictates otherwise. Thus, reference to “apicnic basket having an apple” describes “a picnic basket having atleast one apple” as well as “a picnic basket having apples.” Incontrast, reference to “a picnic basket having a single apple” describes“a picnic basket having only one apple.”

When used herein to join a list of items, “or” denotes “at lease one ofthe items,” but does not exclude a plurality of items of the list. Thus,reference to “a picnic basket having cheese or crackers” describes “apicnic basket having cheese without crackers”, “a picnic basket havingcrackers without cheese”, and “a picnic basket having both cheese andcrackers.” Finally, when used herein to join a list of items, “and”denotes “all of the items of the list.” Thus, reference to “a picnicbasket having cheese and crackers” describes “a picnic basket havingcheese, wherein the picnic basket further has crackers,” as well asdescribes “a picnic basket having crackers, wherein the picnic basketfurther has cheese.”

Additionally, several terms such as “dorsal,” “volar,” “radial,” and“ulnar” are used herein with reference to features of the human hand.Indeed, descriptions herein of one or more illustrated embodiments ofthe invention sometimes are made with such terms that may imply that theembodiment is disposed on a forearm and hand. Use of such terms ofreference is made herein in order to facilitate an understanding of theinvention, and the forearm and the hand are not considered in suchembodiments to be actual elements of the invention.

Moreover, for the purpose of interpreting these terms of reference, thereader should consider a forearm and open hand resting palm-side downupon a planar desktop, with the forearm and palm generally contactingthe desktop, and with the fingers and thumb generally straight andresting their lengths on the desktop. The volar sides of the forearm,wrist, hand, and fingers are generally disposed toward and contact thedesktop. Thus, the fingerprints generally are found on the volar sidesof fingertips. The dorsal sides of the forearm, wrist, hand, and fingersgenerally face in opposite direction to the volar sides of the forearm,wrist, hand, and fingers. These dorsal sides thus would be generallyoriented away from the desktop. For example, fingernails generally growfrom the dorsal sides of the fingers. The side of the hand from whichthe thumb depends defines the radial side of the forearm, wrist, andhand. In contrast, the side of the hand opposing the radial side definesthe ulnar side of the forearm, wrist, and hand. For example, the fourthfinger from the thumb of the hand, generally the smallest finger oftencalled the “pinkie” finger, depends from the ulnar side of the hand. Inview of these clarifications, these terms of reference are unambiguousand are well-defined with regard to essentially any hand or wrist,including both the left hand and right hand.

Regarding the views of the figures, dorsal views herein refer to viewsdirected toward dorsal sides. For example, a dorsal view of a hand showsthe dorsal side of the hand, which side is sometimes called the back ofthe hand. Similarly, a radial view of a hand generally would include ashowing of the thumb, a volar view of a hand generally would include ashowing of the palm, and an ulnar view of a hand generally would includea showing of the fourth finger from the thumb.

Regarding planes and axes, volar-dorsal planes are generallyperpendicular to radial-ulnar planes, and the forearm generally definesa longitudinal axis. The reader should consider again the forearm andhand resting palm-side down on a planar desktop, particularly when thehand and forearm are comfortably aligned and the fingers are extendedstraight and held tightly together. In this disposition of the forearmand hand, the plane of the desktop defines a radial-ulnar plane; alongitudinal axis is defined along the length of the forearm; and thefour fingers of the hand extend generally parallel to the longitudinalaxis. Furthermore, rotation of a radial-ulnar plane by ninety degreesabout the longitudinal axis produces a volar-dorsal plane. For example,when a postcard is slipped between adjacent fingers such that an edge ofthe postcard abuts the desktop and is held parallel to the longitudinalaxis, and such that the postcard stands vertically and ninety degreesfrom the plane of the desktop, the postcard defines a volar-dorsalplane.

Furthermore, terms of reference such as “phalanx,” “phalange,” and“interphalangeal joint,” which terms are well-known and are found in theprior art, may be used herein with reference to the skeletal anatomy ofthe human hand. Indeed, descriptions herein of one or more illustratedembodiments of the invention sometimes are made with such terms that mayimply that the embodiment is disposed on or abuts the hand. Use of suchterms of reference is made herein in order to facilitate anunderstanding of the invention while the hand and portions thereof arenot necessarily considered in such embodiments to be actual elements ofthe invention.

Nonetheless, for the purpose of interpreting these terms of reference,reference is herein made to the fourth figure of U.S. Pat. No. 5,676,157to Kramer, which issued on Oct. 14, 1997 (the “Kramer patent”). In thefourth figure of the Kramer patent, which figure is hereby incorporatedherein by reference, the skeletal anatomy of a human hand is illustratedwherein particular bones and joints defined therebetween are identified.For the purpose of interpreting terms of reference as used herein, thefourth figure of the Kramer patent may be regarded as a dorsal view of aright hand. As shown and as is commonly known, five digits, including athumb and four fingers, depend from the hand. The three bones of any oneof the four fingers, disposed in increasing distance from the hand, arereferred to as: the proximal phalange (or proximal phalanx); the middlephalange (or middle phalanx); and the distal phalange (or distalphalanx). A section of a finger may be referred to herein with regard toa particular phalange without ambiguity in that such a section wouldinclude the particular bony phalange and the flesh of the finger aboutthe phalange. For example, in typing or in entering data using akeyboard, distal phalange sections of the fingers generally abut andactuate keys of the keyboard without regard to whether distal phalangebones, which are generally surrounded by the flesh of the fingers, everdirectly contact the keyboard.

With regard to joints, for each of the four fingers illustrated in thefourth figure of the Kramer patent, a proximal interphalangeal joint isdefined between the proximal phalange and the middle phalange, and adistal interphalangeal joint is defined between the middle phalange andthe distal phalange. The thumb, however, having less joints than each ofthe four fingers, generally includes an interphalangeal joint, indicatedin the fourth figure as “THUMB IP,” defined between a proximal phalange(or proximal phalanx) and a distal phalange (or distal phalanx). Thus,any recitation herein relating to the “last joint” or “distal joint” ofa digit relates equally to any distal interphalangeal joint of a fingerand to any interphalangeal joint of a thumb regarding either a left handor a right hand.

Turning now to the drawings of the present application, preferredembodiments of a dynamic hand splint of the present invention areillustrated and are described in detail below. It should be furthermoreunderstood that the views found in the accompanying drawings relate to adynamic hand splint for a right forearm, wrist, and hand. Nevertheless,the accompanying drawings and the descriptions herein relate equally aswell to a dynamic hand splint for a left forearm, wrist, and hand when amirror image of the various drawings is considered.

Each preferred embodiment comprises a dynamic splint for the positioningand exercise of a neurologically impaired upper extremity, including thewrist, hand, and fingers, and is specifically directed towards a dynamicsplint that exercises a rehabilitating hand by providing resistance tothe hand's fingers and thumb. Each of these embodiments is especiallyuseful for returning the fingers and thumb to an open or extendedposition after a grasping motion has been carried out and, specifically,is used to hold the user's impaired wrist, hand and fingers generally inan extended position, with the thumb in palmer abduction. This positionplaces the impaired hand in the functional position for grasping. Eachembodiment thus allows a neurologically impaired upper extremity,including the hand, to work on repetitive grasp-and-release activitieswhile participating in task-specific arm training Each embodimentfurther has a dynamic characteristic that offers varying degrees ofsubstantial resistance to the digits.

The First Embodiment

A dynamic hand splint 10 in accordance with a first preferred embodimentof the present invention is illustrated in FIGS. 1A-1C. The splint 10includes a forearm support section 12 and a hand support section 14. Asshown, the forearm support section 12 and the hand support section 14(including both the portions, described below, that are related to thefingers and to the thumb) are integrally formed and together constitutea component of the dynamic hand splint. Alternatively, however, theforearm support section 12 and the hand support section 14 are notintegral but, instead, are attached together directly or indirectlythrough an intermediate connector such as hook-and-loop fasteners (ofwhich the second and third embodiments disclosed below are exemplary).Also alternatively, the portion of the hand support section 14 that isrelated to the fingers and the portion of the hand support section 14that is related to the thumb are not integral but, instead, areseparately attached to the forearm support section 12 (of which thesecond and third embodiments discussed below are likewise exemplary).

Both the forearm support section 12 and the hand support section 14 areconstructed of a pliable, malleable material, e.g., a plastic or metalsheet that can be readily manipulated and shaped by a healthcareprofessional. In this regard, the forearm support section 12 preferablycan be bent upward or downward, as desired, in the area of the wrist inorder to position the wrist at a selected one of a wide variety ofangles when the dynamic splint is used. In use, the forearm supportsection 12 is adjusted so that the hand support section 14 is positionedat an upward angle to the forearm support section 12 so that the wristis positioned upwardly (which angle is exemplified by the second andthird embodiments disclosed below). Similarly, the hand support section14 preferably can be bent in an arch in order to support and maintain aparticular palmer arch of a hand.

The forearm support section 12 itself is configured and dimensioned toextend along a forearm from the wrist rearwardly preferably about fiveinches. The forearm support section 12 also preferably includes one ormore straps for securing the forearm support section 12 in properdisposition to the forearm. Such straps may include hook-and-loopfasteners such as VELCRO.®. fasteners. Alternatively, the forearmsection 12 is configured to cover the dorsal side of the forearm and maysubstantially encircle the forearm to provide a friction, interferencefit with the forearm (of which configuration the second and thirdembodiments disclosed below are exemplary).

As illustrated, a releasable fastener such as a strap 40 has a first endattached to the dorsal side of the forearm support section 12. The strap40 includes an area 42 of loops proximate its first end, and the strap40 includes a second end having an area 44 with mating hooks forhook-and-loop engagement with the area 42 of loops. In this respect, thestrap 40 includes a length that is sufficient to wrap around the forearmto effect the hook-and-loop engagement. The inner surface of the forearmsupport section 12 further is preferably lined with a padding material(not shown) for comfort.

The hand support section 14 is dimensioned and configured to cover asubstantial portion of the dorsal part or dorsum of the hand between themetacarpophalangeal joints and the carpals, i.e., between the base ofthe fingers and the wrist. The hand support section 14 also preferablyincludes one or more straps for securing the hand support section 14 inproper disposition on the back of the hand. Such straps may includehook-and-loop fasteners such as VELCRO.®. fasteners.

As illustrated, a releasable fastener such as a strap 34 has a first endattached to the dorsal side of the hand support section 14. The strap 34includes an area 36 of loops proximate its first end, and the strap 34includes a second end having an area 38 with mating hooks forhook-and-loop engagement with the area 36 of loops. In this respect, thestrap 34 includes a length that is sufficient to wrap around the palm ofthe hand to effect the hook-and-loop engagement. The inner (volar)surface of the hand support section 14 further is preferably lined witha padding material (not shown) for comfort.

The first embodiment 10 additionally includes tensioners comprising aplurality of struts 18,20,22,24 for attachment to respective fingers ofthe hand. Each strut 18,20,22,24 furthermore is preferably constructedfrom a resilient material and is approximately the length and width ofthe digit to which it is to be attached.

Suitable struts may comprise, for example, resilient strips of about0.01- to 0.008-inch stainless steel that are semi-rigid but neverthelessexhibit spring-like qualities and that may be generally rectangular incross-section. Alternatively, the struts may be circular or oval incross-section and comprise rods. Semi-rigid, resilient rods areconventional and are disclosed, for example, in U.S. Pat. No. 5,453,064to Williams, Jr. (the “Williams patent”).

Such rods as disclosed in the Williams patent are made of a materialsuch as a composite and can be formed from a hardenable mixture offilaments or fibers saturated in a resin system, or can be made of anyother resilient material with a suitable toughness to give a usefulflexural fatigue life, such as advanced composite thermoplastics,thermosets, engineered plastics, or fiber reinforced plastics. Thepreferred rods of the Williams patent are formed from Owens-CorningS2-glass with a matrix material of an epoxy or a resin and compriseabout 65 to about 70 volume percent S2-glass in an epoxy matrix, givingthe rods an appropriate desired flexural strength.

Each of the struts 18,20,22,24 is configured at a distal end thereof tobe secured to a distal portion of a respective finger of the hand. Asillustrated, each strut 18,20,22,24 includes a releasable fastenercomprising a strap 28 having a first end attached to the dorsal side ofthe respective strut 18,20,22,24. Each strap 28 includes an area 30 ofloops proximate its first end, and the strap 30 includes a second endhaving an area 32 with mating hooks for hook-and-loop engagement withthe area 30 of loops. In this respect, the strap 28 is of a length thatis sufficient to wrap around the respective finger of the hand to effectthe hook-and-loop engagement. The inner surface of the strut 18,20,22,24further is preferably lined with a padding material (not shown) forcomfort.

Each strut 18,20,22,24 is also releasably attached to the hand supportsection 14 by a respective clip 26 mounted on the dorsal side of thehand support section 14. As illustrated, the hand support section 14includes four such clips 26 into which the proximal ends of the struts18,20,22,24 are inserted. Each attachment clip 26, illustrated ingreater detail in FIG. 1C, includes a channel formed by facingC-sections and a detent 46 that extends upwardly from the floor of thechannel. Each strut 18,20,22,24—exemplified by strut 18 in FIG.1C—includes a plurality of axially aligned openings 48 selectivelymateable with the detent 46 to secure and lock the strut 18,20,22,24within the channel The detent 46 further is selectively displaceable,whereby the strut 18,20,22,24 may be linearly retracted or extendedrelative to the hand support section 14 to adjust for the length of aparticular finger. Furthermore, the cross-section of each clip 26 isshaped and dimensioned such that the channel created thereby hasapproximately the cross-sectional shape of the strut 18,20,22,24,thereby minimizing any play that otherwise might be exhibited by thestrut 18,20,22,24 when secured within the channel by the protuberance46. Alternatively, in an arrangement not illustrated herein, the strut18,20,22,24 may include a detent that is selectively insertable into oneof a plurality of openings in the bottom of the channel

As illustrated, the hand support section 14 also includes a tensionercomprising strut 16 for attachment to a thumb. The thumb strut 16 issimilar to each of the finger struts 18,20,22,24. The thumb strut 16 ispreferably also constructed from a resilient material and isapproximately the length of the thumb to which it is to be attached. Asuitable strut may comprise, for example, a thin resilient strip ofabout 0.01- to 0.008-inch stainless steel that is semi-rigid butnevertheless exhibits spring-like qualities.

The thumb strut 16 also is configured at a distal end thereof to besecured to a distal portion of the thumb. As illustrated, the strut 16includes a releasable fastener comprising a strap 28 having a first endattached to the dorsal side of the strut 16. Like the straps 28 used forthe finger struts 18,20,22,24, this strap 28 includes an area 30 ofloops proximate its first end, and the strap 28 includes a second endhaving an area 32 with mating hooks for hook-and-loop engagement withthe area 30 of loops. In this respect, the strap 28 is of a length thatis sufficient to wrap around the thumb to effect the hook-and-loopengagement. The inner surface of the strut 16 further is preferablylined with a padding material (not shown) for comfort.

The thumb strut 16 is also releasably attached to the hand supportsection 14 by a clip 26 mounted on the dorsal side of the hand supportsection 14 in the same manner by which each of the finger struts18,20,22,24 is mounted to a respective clip 26.

As will be appreciated by the Ordinary Artisan, while the preferredembodiment 10 of FIGS. 1A, 1B, and 1C includes struts 16,18,20,22,24 forall five digits, a dynamic hand splint alternatively may include onlystruts and associated clips for one or more fingers, for just the thumb,or for any of the possible combination of digits, as desired.

In use of the dynamic hand splint 10 of FIGS. 1A-1C, the forearm supportsection 12 and the hand support section 14 are shaped or adjusted asdesired. In this respect, a healthcare worker, the wearer himself, oranother user preferably shapes the support sections 12,14 by arching thehand support section 14 to accommodate the palmer arch of the hand ofthe wearer, and by bending the forearm section 12 to achieve the desiredangle for positioning of the wrist of the wearer.

The struts 16,18,20,22,24 having the respective, desired resilience areinserted into the clips 26 at the appropriate lengths to match thelengths of the digits of the wearer. The forearm support section 12 andthe hand support section 14 then are secured on the dorsal sides of thewearer's hand and forearm with respective straps 40,34, and each of thestruts 16,18,20,22,24 are secured onto the digits of the hand with thestrut straps 28.

Once attached, the dynamic splint 10 creates rearwardly-directed forcesthat urge the fingers and thumb into an open hand position in which thefingers and thumb are extended. However, the resistance provided by eachof the digit tensioners, i.e., each of the struts 16,18,20,22,24 in thepreferred embodiment 10, is not so great as to prevent the wearer frommoving the fingers and thumb towards a gripping position, therebyallowing the wearer to exercise (and rehabilitate) the hand. Indeed, thedynamic splint 10 will generally position the wrist into extension withthe digits extended, whereby the wearer will be in a position to graspan object, and after the wearer grasps the object, the dynamic splint 10then will assist in reopening of the digits so the wearer will onceagain be in a position to grasp an object. Furthermore, the struts16,18,20,22,24 may be replaced by struts of different degrees ofresilience, whereby the healthcare worker, the wearer or another usercan continue to select struts with the desired resistance for each digitas the healing and rejuvenation process progresses.

The Second Embodiment

A dynamic hand splint 20 in accordance with a second preferredembodiment of the present invention is illustrated in FIGS. 2A and 2B.As with the splint 10 of FIGS. 1A-1C, this second splint 20 includes aforearm support section 112 and a hand support section 114. Unlike theforearm support section 12 and the hand support section 14 of the splint10 of the first embodiment, however, the forearm support section 112 andthe hand support section 114 of the splint 20 of the second embodimentare not integrally formed but, instead, comprise two separate componentsof the dynamic hand splint 20. As such, the forearm support section 112may be separately donned prior to donning of the hand support section114.

The forearm support section 112 of the splint 20 of the secondembodiment is preferably flexible and may be constructed from anysuitable plastic, metal, or alloy material. The forearm support section112 also preferably is configured and dimensioned to extend along aforearm from the wrist rearwardly for a distance of at least severalinches, and is generally tubular and designed to surround the wrist anda portion of the forearm. The forearm support section 112 may be donnedand doffed through a small opening or slot 111 that extends the completelength of the forearm support section 112 along the ulnar side of thewrist and forearm.

The forearm support section 112 also preferably is lined with apermanent or removable close cell foam padded lining (not shown) and isadapted to tightly fit around the wrist and forearm in a frictional,interference fit. The lining optionally may include a non-skid materialon the inner surface thereof to help prevent distal migration of theforearm support section 112.

Additionally, the forearm support section 112, when manufactured in aninjection molding process, preferably includes an area 144 of hooks thatis formed during the injection molding process as an integral part ofthe forearm support section 112. The area 144 of hooks preferably isadapted to attach to loops in conventional hook-and-loop attachment suchas exemplified in VELCRO.®.-type attachments. Forming an area of hooksin an injection molded process is known and disclosed, for example, inU.S. Pat. No. 5,656,226 to McVicker.

The area 144 of hooks preferably is formed so as to substantially coverthe outer surface of the forearm support section 112 extending betweenopposite ends thereof defining the slot 111 on the ulnar side of theforearm support section 112. The area 144 of hooks receives inhook-and-loop attachment areas of loops of a strap 140 of the forearmsupport section 112 (one such area 142 being shown in FIG. 2A). Thestrap 140 is used to further secure the forearm support section 112 inits proper disposition to the forearm when needed. The strap 140 ispreferably dimensioned and configured to extend substantially around theforearm support section 112 in covering relation not only to the slot111 of the forearm support section 112, but also to a base 117 of thehand support section 114. Disposition of such covering attachment of thestrap 140 is illustrated by an arrow 141 in FIG. 2A. To facilitate this,the area 144 of hooks on the forearm support section 112 is also adaptedto receive on the dorsal side thereof a plurality of loops (not shown)disposed on the underside of the hand support section 114 for removableattachment of the base 117 of the hand support section 114 to theforearm support section 112. In addition, the area 144 of hooks on theforearm support section 112 is adapted to receive on the radial sidethereof another plurality of loops (not shown) disposed on the thumbstrut 116 for removable attachment (indirectly) of the thumb strut 116to the forearm support section 112. The base 117 and platform 115elements of the hand support section 114 and the thumb strut 116 aredescribed in further detail below.

The hand support section 114 covers a portion of the dorsum of the hand.In particular, the hand support section 114 includes a platform 115 thatis dimensioned and configured to extend between the radial side of thehand proximate the index finger (sometimes referred to as digit #2)across the dorsum of the hand to the ulnar side of the hand proximatethe little finger (sometimes referred to as digit #5), and between themetacarpophalangeal joints and the carpals, i.e., between the base ofthe fingers and the wrist. The hand support section 114 further includesa base 117 that is integral with the platform 115 and that isdimensioned and configured to extend from the wrist several inches upthe wrist, but preferably does not extend past the distal end of theforearm support section 112, i.e., the end of the forearm supportsection 112 that is distal to the wrist.

The hand support section 114 preferably is constructed from a pliable,malleable material, e.g., a plastic or metal sheet that can be readilymanipulated and shaped by a healthcare professional, the wearer, oranother user. In this regard, the hand support section 114 preferablycan be bent upward or downward at the juncture between the platform 115and the base 117, as desired, such juncture being in the area of thewrist, in order to position the wrist at a selected one of a widevariety of angles when the dynamic splint 20 is used in order toaccommodate wrist flexion and/or extension. Thus, in use, the handsupport section 114 preferably is shaped so that the wrist is positionedupwardly as illustrated in FIG. 2A.

As alluded to previously, the hand support section 114, and specificallythe base 117, preferably includes an area of loops (not shown) on theinner (volar) side of the hand support section 114 whereby the handsupport section 114 is secured in proper disposition to the area 144 ofhooks of the forearm support section 112. The base 117 of the handsupport section 114 also may be lined in areas with a padding material(not shown) for comfort.

The dynamic splint 20 of the second embodiment additionally includestensioners comprising a plurality of struts 118,120,122,124 forattachment to respective fingers of the hand. Each strut 118,120,122,124furthermore is preferably constructed from, for example, spring steeland is formed to have a thin or flat profile. The struts 118,120,122,124further preferably are constructed to have varying degrees of resistancedepending upon such factors as the thickness of the struts118,120,122,124 and materials from which the struts 118,120,122,124 aremade. Different resistances may be preferred for use with fingers havingdifferent characteristics of overall tone, tissue softness, and length.Each strut 118,120,122,124 also preferably corresponds in length andwidth to the finger to which it is to be attached. Suitable struts118,120,122,124 may comprise, for example, thin resilient strips ofabout 0.01 to 0.008 inch stainless steel that is semi-rigid butnevertheless exhibits spring-like qualities.

Each strut 118,120,122,124 is designed to be secured to a respectivefinger of the hand. As illustrated in FIGS. 2A and 2B, this isaccomplished in the second dynamic splint 20 by insertion of each strut118,120,122,124 in a respective elongate pocket 130, each elongatepocket 130 being disposed in a respective finger sleeve 128. The fingersleeves 128 resemble the finger sleeves of a glove and, preferably, areintegrally formed. Each of the finger sleeves 128 further preferably isconfigured to enclose a respective one of the fingers, i.e., digit #2through digit #5. The splint 20 of the second embodiment also preferablyincludes a covering 132 for part of the dorsum of the hand at the baseof the fingers, which covering 132 also preferably is integrally formed,via conventional textile operation, with the finger sleeves 128. Asimilar covering 133 for the palm of the hand may be provided that isintegral with the finger sleeves 128. The pocket 130 of each fingersleeve 128 similarly is preferably integrally formed with its respectivefinger sleeve 128 during a conventional textile operation.

The dorsum covering 132 preferably includes an area of loops (not shown)on the dorsal side thereof for attachment of the dorsum covering 132 toan area of hooks (not shown) of the platform 115 of the hand supportsection 114.

In an alternative construction not illustrated herein, the palm covering133 may be omitted thereby providing for an open-palm construction, andeach finger sleeve 128 may only cover the volar surface of the fingerbetween the tip of the finger and the middle area of the proximalphalanx.

Each strut 118,120,122,124 preferably is releasably attached to the handsupport section 114, and specifically to the platform 115 thereof,through an attachment mechanism 126, best illustrated in FIG. 2B, thatis secured onto the dorsal side of the platform 115 of the hand supportsection 114. Specifically, the attachment mechanism 126 includes ahousing 127, which is secured to the dorsal side of the platform 115 ofthe hand support section 114, and a slider 129, which mates with andslides, in directions designated by arrows 121 in FIG. 2A, on top of thehousing 127. In this respect, the slider 129 includes a C-shaped channel131 on opposite sides thereof that receive ledges 125 of the housing 127in interlocking engagement. The housing 127 further includes grooves 135in which springs 137 are received. The springs 137 abut the housing 127and, when the slider 129 is in interlocking engagement with the housing127, blocks 139 of the slider 129 engage the springs 137 and compressthe springs 137 when the slider 129 moves away from the base 117. Thiscompression occurs when the struts 118,120,122,124 are extended duringclosing of the fingers, and the springs 137 assist in opening of thefingers by urging retraction of the struts 118,120,122,124, as describedin detail below.

Each strut 118,120,122,124 is mounted to the slider by two fastenerspreferably comprising screws 151,153. A first screw 151 extends througha curved slot 155 formed in the respective strut 118,120,122,124 and isreceived in mating engagement within a threaded opening 157 in theslider 129. A second screw 153 extends through a circular opening 159formed in the respective strut 118,120,122,124 and is received in matingengagement within another threaded opening 161 in the slider 129. Due tothis arrangement, each respective strut 118,120,122,124 is capable ofrotational movement, in a respective direction designated by arrows 163,about its second screw 153, with its first screw 151, extending throughits curved slot 155, acting as a stop defining the limits of suchrotation. Moreover, either screw 151,153 further may be tightened tolock the strut in a particular orientation.

As illustrated, the dynamic splint 20 of the second preferred embodimentalso includes a tensioner comprising strut 116 for attachment to athumb. The strut 116 furthermore is preferably constructed from, forexample, spring steel and is formed to have a thin or flat profile.Suitable struts may comprise, for example, thin resilient strips ofabout 0.01 to 0.008 inch stainless steel that is semi-rigid butnevertheless exhibits spring-like qualities.

The thumb strut 116 further preferably corresponds in length and widthto the thumb to which it is to be attached. The attachment isaccomplished by insertion of the strut 116 into an elongate pocket 190of a thumb sleeve 188. The thumb sleeve 188 preferably is configured toenclose a thumb, and the pocket 190 of the thumb sleeve 188 preferablyis integrally formed in the thumb sleeve 188 in a textile operation.

The strut 116 preferably is releasably attached indirectly to theforearm support section 112 through a thumb support section 514 that,similar to the hand support section 114, includes a platform 515 and abase 517. In this respect, an attachment mechanism 186 is secured on thedorsal side of the platform 515 and functions to movably mount the strut116 to the platform 515.

The base 517 of the thumb support section 514 includes an area of loops(not shown) on the volar side thereof for engagement with the area 144of hooks on the forearm support section 112. The thumb support section514, and in particular the base 517, preferably is configured anddimensioned such that, when it is worn, it includes a bend proximate thecarpals of the wrist, spans the wrist joint, and preferably extends aninch or more along the forearm support section 112. Preferably the thumbsupport section 514 may thereby be selectively bent to various degreesof flexion and extension at the carpals in order to allow the thumb tobe positioned in varying degrees of thumb abduction, adduction, andopposition, depending on where the attachment mechanism 186 is attachedto the thumb support section 514.

With respect to the attachment mechanism 186, a slider 189 mates withand slides, in directions designated by arrows 181 in FIG. 2A, on top ofthe housing 187. In this respect, the slider 189 includes a C-shapedchannel 191 on opposite sides thereof that receive side ledges 185 ofthe housing 187 in interlocking engagement, similar in manner to thehousing 127 and slider 129 as discussed above.

Also in similar manner, the housing 187 further includes a groove 195 inwhich a spring 197 is received. The spring 197 abuts the housing 187and, when the slider 189 is in interlocking engagement with the housing187, a block 199 of the slider 189 engages the spring 197 and compressesthe spring 197 when the slider 189 moves in a direction toward the thumbsleeve 188. This compression occurs when the strut 116 is extendedduring closing of the hand, and the spring 197 assists in opening of thehand by urging retraction of the strut 116 and extension of the thumb,as described in detail below.

The strut 116 is mounted to the slider 189 by two fasteners preferablycomprising screws 201,203. A first screw 201 extends through a curvedslot 205 formed in the strut 116 and is received in mating engagementwithin a threaded opening 207 in the slider 189. A second screw 203extends through a circular opening 209 formed in the strut 116 and isreceived in mating engagement within another threaded opening 211 in theslider 189. Due to this arrangement, the strut 116 is capable ofrotational movement, in the direction designated by the arrow 213, aboutthe second screw 203, with the first screw 201, extending through thecurved slot 205, acting as a stop defining the limits of such rotation.

As will be appreciated by the Ordinary Artisan, while the dynamic splint20 of the preferred embodiment of FIGS. 2A and 2B includes struts116,118,120,122,124 for all five digits, a dynamic hand splintalternatively may include only struts for one or more fingers, for justthe thumb, or for any of the possible combination of digits, as desired.

Moreover, as will now be apparent, the strut 116 and attachmentmechanism 186 for the thumb, as well as the thumb sleeve 188, may beseparately and independently donned and doffed with respect to thestruts 118,120,122,124 and attachment mechanisms 126 for the fingers, aswell as the finger sleeves 128 and dorsum covering 132. Donning anddoffing of a hand splint by a neurologically impaired or hemipareticperson can be problematic, especially when such a person only has theuse of a single hand. Accordingly, the hand splint 20 of this secondpreferred embodiment (and the third preferred embodiment describedbelow) is more readily donned and doffed by such a person.

In use of the dynamic hand splint 20 of this preferred embodiment, theforearm support section 112 is positioned onto the forearm. The handsupport section 114 also is shaped as desired to position the wristrelative to the forearm. In this respect, a healthcare worker, thewearer himself, or another user preferably bends the hand supportsection 114 to achieve the desired angle for positioning of the wrist.The hand support section 114 is positioned or repositioned along thedirection of arrows 119 on the forearm support section 112 such that thebend in the hand support section 114 is proximate to the wrist.

Struts 118,120,122,124 having the respective, desired resilience alsoare attached to the slider 129 via the screws 151,153; the slider 129 isengaged with the housing 127; the housing 127 is attached to theplatform 115 of the hand support section 114; and the struts118,120,122,124 are inserted into the pockets 130 of the respectivefinger sleeves 128 and each strut 118,120,122,124 is oriented in thedesired rotational position. A strap 109 of the dorsum covering 132(optionally provided) further may be fastened over the ends of thestruts 118,120,122,124 and the attachment mechanism 126 for coveringthereof. In this scenario, the strap 109 includes an area of loops (notshown) for engagement with areas of hooks (not shown) of the dorsumcovering 132.

The strut 116 for the thumb also is shaped and manipulated to positionthe thumb relative to the forearm support section 112, and the strut 116having the desired resilience is attached to the slider 189 via thescrews 201,203; the slider 189 is engaged with the housing 187; thehousing 187 is attached to the platform 515 of the thumb support section514; and the strut 116 is inserted into the pocket 190 of the thumbsleeve 188 and is oriented in the desired rotational position. The strap142, when provided, also preferably extends over and covers the base 517of the thumb support section 514 including the attachment mechanism 186in its disposition on the forearm support section 112.

Once attached, the dynamic splint 20 creates rearwardly-directed forcesthat urge the fingers and thumb into an open hand position in which thefingers and thumb are extended. However, the resistance provided by eachof the digit tensioners, i.e., each of the struts 116,118,120,122,124 inthe preferred embodiment 20, is not so great as to prevent the wearerfrom moving the fingers and thumb towards a gripping position, therebyallowing the wearer to exercise (and rehabilitate) the hand. Indeed, thepreferred embodiment 20 will generally position the wrist into extensionwith the digits extended, whereby the wearer will be in a position tograsp an object and, after grasping of the object, the preferredembodiment 20 then will assist in reopening of the digits so the wearerwill once again be in a position to grasp an object. Furthermore, eachof the struts 116,118,120,122,124 may be replaced by struts of differentdegrees of resilience, whereby the healthcare worker, the wearer, oranother user can continue to select struts with the desired resistancefor each digit as the healing and rejuvenation process progresses.

The Third Embodiment

A dynamic hand splint 30 in accordance with a third preferred embodimentof the present invention is illustrated in FIGS. 3A and 3B and isgenerally similar in design to the second hand splint 20 of FIGS. 2A and2B. Due to the similarity, and in the interests of brevity, onlydifferences in the designs of the second and third illustratedembodiments of the dynamic hand splints 20,30 will be described.

In this regard, the principle difference in design relates to the fingerand thumb tensioners and attachment of the finger and thumb tensionersto the sleeves 128,188. Specifically, whereas the tensioners in thesecond embodiment of the hand splint 20 comprise resilient struts116,118,120,122,124 such as, for example, strips of spring steel orcomposite rods, that are secured to the sleeves 128,188 by pockets130,190, the tensioners of the hand splint 30 of the third embodimentmay be thinner and may comprise resilient bands 301 that are secured tothe sleeves 128,188 via anchor guides 303,305,307. In particular, eachband 301 is secured to a respective sleeve 128,188 via a plurality ofanchor guides 303,305,307 between which the band 301 extends, with ananchor guide 303,305,307 being disposed proximate each phalanx of therespective digit.

Thus, referring to FIG. 3B, a band 301 is illustrated as extending fromthe attachment mechanism 186 along the finger sleeve 128 covering theindex finger. The band 301 is secured to the sleeve 128 by three anchorguides 303,305,307 with each anchor guide 303,305,307 being disposedproximate a separate phalanx of the index finger. Each anchor guide303,305,307 preferably is formed from a rubber material and defines aslot through which the band 301 is threaded. The last anchor guide 307further preferably receives and retains an end cap 309 of the band 301for retention of the end of the band 301 within the anchor guide 307during closing and opening of the hand.

The bands 301 of the splint 30 of the third embodiment are generallymore flexible than the struts 116,118,120,122,124 of the first andsecond embodiments. Nevertheless, bands having differing elasticity andresilience may be provided and the bands 301 may be changed as desiredfor providing more or less resistance to the closing of the hand.Additionally, elastic or inelastic bands may be used in accordance withthe third embodiment (the elasticity in this regard being in thedirection of length of the bands), which additionally contributes toresistance to closing of the hand.

In view of the foregoing, it will be appreciated that several preferredembodiments of dynamic hand splints 10,20,30 of the present inventionhave been disclosed and described in detail with reference to thedrawings. Furthermore, other embodiments having alternative orequivalent features also have been and are disclosed, and equally arewithin the scope of the present invention. For instance, areas havingloops and areas having hooks may be reversed in the aforementionedembodiments. Furthermore, while tensioners have been disclosed asextending along the dorsum of a respective digit, the tensioners mayextend instead along a side of the respective digit and may be retained,for example, either in an elongate side pocket or by anchor guidesmounted along the side. Moreover, while a single band is disclosed asextending the length of each digit and passing through multiple anchorguides, with segments of the same band extending between each pair ofanchor guides, a plurality of smaller bands may extend between theanchor guides in substitution for the segments of the single band,thereby providing a substantially equivalent resistance to bending ofthe digit.

1. A dynamic hand splint, comprising: (a) a forearm support sectionconfigured to be releasably attached to a forearm; (b) a hand supportsection connected to the forearm support section; (c) a sleeveconfigured to receive a digit therein; and (d) a tensioner having aresilient body having a first end and an opposite second end, wherein)(i) the tensioner first end is non-slidably fixed to and extends fromthe hand support section, and (ii) the tensioner second end is retainedto the sleeve at a first location of the sleeve and at a second locationof the sleeve such that the tensioner second end is slidable relative tothe sleeve, the first and second locations being spaced apart such thatthe resilient body spans a joint of the digit when received within thesleeve with the first and second locations being located longitudinallyon opposite sides of the joint; (e) wherein the resilient body hassufficient flexural strength to resist, but not prevent, bending of thedigit received within the sleeve such that, when the digit is flexedfrom an extended position toward a flexed position, the resilient bodyof the tensioner bends with the digit and the digit is urged by thetensioner toward the extended position, and the tensioner second endslides relative to the sleeve.
 2. The dynamic hand splint of claim 1,wherein the tensioner is a fixed length that is not extendable when thedigit is flexed from the extended position toward the flexed position.3. The dynamic hand splint of claim 1, wherein the forearm supportsection comprises a malleable material and includes a bend therein,whereby the forearm support section is configured to determine an angleat which a wrist will be disposed relative to the forearm when theforearm support section is donned.
 4. The dynamic hand splint of claim1, wherein the tensioner is pivotally mounted to the hand supportsection for abductional and adductional movement relative to the handsupport section.
 5. The dynamic hand splint of claim 1, wherein thetensioner is linearly movable relative to the sleeve to allow thetensioner to slide relative to the digit.
 6. The dynamic hand splint ofclaim 1, wherein the sleeve further comprises a first guide that isattached to the sleeve at the first location and a second guide that isattached to the sleeve at the second location, and wherein the tensioneris retained to the sleeve by the first and second guides.
 7. The dynamichand splint of claim 6, wherein each of the first and second guidesdefines an opening through which the tensioner extends.
 8. The dynamichand splint of claim 7, wherein the tensioner comprises a thin band andthe openings of the first and second guides comprise slits through whichthe band extends.
 9. The dynamic hand splint of claim 8, wherein thetensioner is configured to slide relative to the first and secondguides.
 10. The dynamic hand splint of claim 1, wherein the digit is afinger.
 11. The dynamic hand splint of claim 1, wherein the resilientbody of the tensioner is configured to extend along and in parallel witha majority of an overall length of the digit.
 12. A dynamic hand splint,comprising: (a) a forearm support section and a hand support sectionthat are configured to be releasably attached to a forearm; (b) aplurality of tensioners that are non-slidably fixed to the hand supportsection and that are slideably attached to respective digits throughrespective sleeves such that, when a digit is flexed from an extendedposition toward a flexed position, each tensioner moves with respect toits respective sleeve and the digit is urged by a respective tensionertoward the extended position; and (c) wherein each of the plurality oftensioners is slidably attached to the respective sleeve at at least afirst location, each tensioner thereby being linearly movable relativeto the respective sleeve to allow the tensioner to remain positionedover its respective digit throughout flexion and extension.
 13. Thedynamic hand splint of claim 12, wherein each sleeve includes a pocketthat extends substantially along a length of the respective sleeve andeach tensioner is slidably received in the pocket of one of the sleevessuch that each tensioner slides within the respective pocket as therespective digit undergoes flexion and extension.
 14. The dynamic handsplint of claim 12, wherein each tensioner is further slidably retainedto the respective sleeve at at least a second location of the respectivesleeve, the first and second locations being spaced apart such that theresilient body of each tensioner spans a joint of the respective digitwhen received within the sleeve, with the first and second locationsbeing located longitudinally on opposite sides of the joint.
 15. Thedynamic hand splint of claim 14, wherein each sleeve further comprises afirst guide that is attached to the sleeve at the first location and asecond guide that is attached to the sleeve at the second location, andwherein each tensioner is retained to the respective sleeve by the firstand second guides.
 16. The dynamic hand splint of claim 15, wherein eachof the first and second guides defines an opening through which therespective tensioner extends.
 17. The dynamic hand splint of claim 16,wherein each tensioner comprises a thin band and the openings of thefirst and second guides comprise slits through which the band extends.18. The dynamic hand splint of claim 17, wherein each tensioner isconfigured to slide relative to the corresponding first and secondguides.
 19. A method for donning elements of a dynamic hand splint,comprising: (a) attaching a forearm support section and a hand supportsection to a forearm and donning a sleeve onto a digit of the hand; (b)attaching a tensioner having a resilient body to the hand supportsection such that the tensioner is non-slidable relative to the handsupport section; (c) attaching the tensioner to the sleeve such that theresilient body of the tensioner extends along and spans a joint of thedigit and is attached to the sleeve longitudinally on opposite sides ofthe joint; and (d) wherein, (i) the resilient body of the tensioner hassufficient flexural strength to resist, but not prevent, bending of thedigit, and (ii) when the digit is flexed from an extended positiontoward a flexed position, the digit is urged by the tensioner toward theextended position and the tensioner remains positioned over the digitthroughout flexion and extension.
 20. The method of claim 19, whereinthe tensioner comprises a resilient band and the step of attaching thetensioner to the sleeve comprises threading the resilient band through aplurality of guides, each guide being secured to the sleeve for keepingthe resilient band off of and out of abutment with one or more joints ofthe digit during flexion.